Hypertension affects millions of Americans, putting 1 in every 3 adults at risk for a heart attack or stroke.

But, there's good news.

There are lots of ways to lower your blood pressure and reduce your risk of developing hypertension. The best approaches involve simple lifestyle changes, like eating healthier, and have the added benefit of improving your overall health, not just regulating blood pressure.

To find out more about what you can do to keep your blood pressure in the healthy normal range, we asked Vera provider, Dr. Marcie Hamrick, to share her thoughts. Here's what she had to say.

Q: What is hypertension? 

Dr. Hamrick: Hypertension, or high blood pressure, is when the pressure inside the blood vessels is higher than what is considered normal. It occurs when there is excess fluid inside the blood vessels when the blood vessels get narrowed by a buildup of fat, cholesterol, calcium, and other substances found in the blood, called plaque, or when the walls of the blood vessels become stiff.

I think of it like a garden hose — when we turn up the flow all the way, if we put a kink in the hose, or if the hose is getting old and rigid — all of these things can increase the pressure inside the hose.

Q: Why is it something to be concerned about?

Dr. Hamrick: Having high pressure inside the blood vessels can cause a variety of problems:

1. The sheer pressure on the inside walls of the blood vessels can cause damage and that damage can cause plaque to stick to the vessel walls more readily, increasing the risk of heart attack, stroke, and peripheral artery disease
2. Pressure can cause aneurysms, where a bulge develops in a weak part of the blood vessel (like what happens to balloons when you blow hard enough into them). Over time, these bulges can weaken and burst, leading to internal bleeding. Common locations of aneurysms are in the brain (where the burst causes a brain bleed or stroke) and in the aorta, the main artery that exits the heart. Ruptures of aneurysms can certainly be deadly
3. High pressure in small blood vessels in the eyes and kidneys can cause visual problems and blindness as well as kidney disease and failure
4. The heart has to work harder to pump blood into a high-pressure system, so the heart muscle over time gets bigger and weaker as a result, which causes congestive heart failure

Q: What are the risk factors for hypertension?

Dr. Hamrick: The main risk factors for hypertension include some things that we can do something about and some things we can’t change. The modifiable risk factors we can change include:

• Being overweight or obese
• Smoking
• Living a sedentary lifestyle
• An unhealthy diet including too much salt
• Too much alcohol
• High cholesterol
• Diabetes
• Untreated sleep apnea
• Unmanaged stress

The risk factors we can’t do anything about include:

• Age - The older we get the more likely our blood pressure goes up
• Genetics - Having family members with hypertension increases our chances
• Gender - Men get high blood pressure more when they’re less than 65 yrs old and women get it more often when they’re older than 65
• Race - African Americans get high blood pressure more than any other racial group

Q: What can people do to reduce hypertension?

Dr. Hamrick: The best things someone can do to help reduce their blood pressure if it’s found to be elevated are:

• Increase their aerobic physical activity by getting 30 minutes of some activity on most days
• Eat a diet with lots of fruits and vegetables
• Limit foods that have a lot of sodium and saturated fats in them
• Lose weight if they are overweight
• Quit smoking if they smoke
• Reduce alcohol to no more than 1-2 drinks/day
• Engage in relaxing activities regularly.

Q: When should people see their provider about hypertension?

Dr. Hamrick: Hypertension is often called the “silent killer” because almost always there are no noticeable symptoms of it until it causes a major (and possibly deadly) problem. For this reason, it’s really important to monitor your blood pressure intermittently.

Often people get their blood pressure checked at a pharmacy, at their local fire station, at their healthcare office, or even at home. If it is ever over 140/90, then you should see your provider to get an evaluation. Many people have their blood pressure checked each year when they have their annual preventive exams, and this is an important reason to have this exam done.

Q: Is there anything else about hypertension you’d like to share?

Dr. Hamrick: Normal readings are 120/80 or less. When blood pressure is 140/90 or greater, it is clear that something needs to be done to help bring the pressure down to prevent the complications we already talked about. When blood pressures are 120-140/80-90 this is a yellow flag which means it is important to begin making some changes to help bring it down to avoid hypertension.

Lifestyle changes are the best way of controlling high blood pressure, and they can have so many other advantages. If lifestyle changes aren’t enough, then it is recommended to help lower blood pressure by adding medications.

Just an interesting tidbit: studies have been done showing that taking 10 min daily to breathe deeply (and therefore more slowly) was an effective way to lower blood pressure in many people. Breathing in this way helps the nervous system relax and can help widen narrowed blood vessels. So I often add this to my patients’ treatment plan. It’s not likely to cause any harm and may be helpful!